Caring for a Senior Horse: Cushing's Disease, Weight, and Adjusted Care

Horses live longer than many people think: 25 to 30 years old is not unusual, and a healthy horse can live comfortably for years past its twentieth birthday. From roughly age fifteen onward, things do start to change, and care shifts from "keep doing what you're doing" to watching closely and adjusting.

When Is a Horse "Old"

There's no hard cutoff. Many horses are still fully in training at fifteen, while another horse the same age is already noticeably slowing down. Roughly speaking, vets consider a horse a senior from age 15 to 18, and a truly old horse from twenty onward. Ponies often live longer than large horses.

Aging is a process, not a disease. What you typically notice first:

• the coat sheds later or incompletely and becomes longer or duller
• the horse loses weight more easily, or conversely gains it more easily
• muscle coverage over the back and hindquarters decreases
• recovery after exertion takes longer
• the teeth wear down, resulting in difficulty chewing

None of these signals on its own calls for panic. Together, though, they're a reason to critically review the routine and have the vet take a look during the annual checkup.

Cushing's Disease (PPID): The Most Common Age-Related Problem

The condition that most often affects older horses is PPID — Pituitary Pars Intermedia Dysfunction, commonly known as Cushing's disease. It's a hormonal condition in which the pituitary gland becomes dysregulated. It mainly occurs in horses over fifteen and cannot be cured, though it can be well managed.

Signals that point toward PPID:

• a long, curly coat that doesn't shed, or sheds poorly (the best-known sign)
• abnormally increased drinking and urinating
• muscle loss, especially over the back, sometimes with a sagging belly
• fat pads in unusual places, for example above the eyes
• recurring infections or slow-healing wounds
• in more severe cases, laminitis

That last one, laminitis, is an acute and painful condition and counts as an emergency: call the vet that same day. PPID and laminitis often occur together.

You don't diagnose PPID yourself. Diagnosis is made through a blood test by the vet. Treatment usually involves daily medication that the horse typically takes for life; the vet determines the dose and product, and you never adjust this yourself. With the right management, many horses go on to live comfortably for years. For the current approach, the vet is the source, not stable gossip.

Weight: Being Too Thin and Too Heavy Are Both a Risk

In older horses, weight can go either way, and both directions need attention.

Being too thin often results from worn teeth that keep the horse from grinding its feed properly, or from a condition like PPID draining energy. You can see the ribs, the topline becomes sharp, and the hindquarters sink in.

Being too heavy is at least as risky. Excess weight increases the risk of laminitis and metabolic problems. A fat horse is not a healthy horse.

A useful measure is the Body Condition Score (BCS), a scale from 1 (skin and bone) to 9 (severely overweight). For most horses, 5 is the target. Learn to feel with your hands along the ribs, neck, and tailhead instead of judging by eye alone — a winter coat hides a lot. Weigh or measure regularly so you spot a trend before it becomes visible.

Adjusting Feed for Worn Teeth

In many old horses, the teeth are the bottleneck. Molars wear down, loosen, or fall out, and long fibers then become difficult to chew.

Special senior feeds are tailored to older horses: easier to digest and often fortified. Have the teeth checked at least once a year by a vet or equine dentist — otherwise a sharp hook or loose molar often isn't noticed until the horse has already started losing weight. Always phase out or switch feed in consultation with a professional, and make changes gradually.

Movement, Leg Health, and Comfort

An old horse needs movement, even if it's no longer ridden under saddle. Standing still worsens stiffness and arthritis, while calm, regular movement keeps joints supple.

Practical points to keep in mind:

• ample turnout (time outside in the pasture) or a paddock is better than long hours in a stall
• build up work and recovery more gradually; an old horse needs longer to warm up and cool down
• watch for signs of arthritis: starting off stiff, shortening in the walk, difficulty turning
• protect against extreme cold and heat — a horse with PPID that sheds poorly can overheat in summer and sometimes needs to be clipped
• keep hooves short and balanced; the farrier (the specialist who trims and shoes a horse's hooves) or trimmer remains necessary every 6 to 8 weeks

Whether an older horse can still compete depends not on age but on health and well-being. Some horses stay fit enough well into their twenties to ride a test (a fixed pattern of movements you ride for the judge) or a course (the jumping course you ride); others are better off retired in the pasture. Make that choice together with the vet based on what the horse can handle, not on what you still want.

In Short

• From roughly age fifteen: critically review your routine and involve the vet at the annual checkup.
• Long, non-shedding coat plus increased drinking/urinating and muscle loss: have the horse tested for PPID (Cushing's disease).
• Keep an eye on weight with the Body Condition Score — being too thin and too heavy are both risks.
• Have the teeth checked at least once a year and adjust feed gradually to what the horse can chew.
• Keep the horse moving and watch for stiffness and arthritis.

When in doubt, and especially with acute symptoms such as laminitis, signs of colic, or sudden severe weight loss, the rule is: the vet is the first step. For diagnosis, medication, and tailored feeding advice, professional guidance leads the way.

See also: Glossary A to Z · Level: Considering Your Own Horse